title: Validation of self-reported colorectal cancer screening behaviors among Appalachian residents.
abstract: OBJECTIVE
  We determined the validity of self-reported colorectal cancer (CRC) screening data provided by Appalachian Ohio residents and identified correlates of providing accurate data.
  
  
  METHODS
  We conducted cross-sectional telephone interviews between September 2009 and April 2010. Our study included Appalachian Ohio residents (n = 721) ages 51-75 years.
  
  
  METHODS
  We compared self-reported CRC screening data to medical records to determine validity. Multivariable logistic regression was used to identify correlates of providing accurate self-reported screening data.
  
  
  RESULTS
  About 68% of participants self-reported having any CRC screening test within recommended guidelines, whereas medical records indicated that only 49% were within guidelines (concordance = 0.76). Concordance was higher for flexible sigmoidoscopy and fecal occult blood test compared with colonoscopy, although sensitivity and positive predictive value were much higher for colonoscopy. Participants overreported CRC screening behaviors for all tests. Participants who had a regular checkup in the last 2 years (OR = 2.78, 95% CI: 1.15-6.73), or who self-rated their health as good or better (OR = 1.88, 95% CI: 1.12-3.16) were more likely to provide accurate screening data.
  
  
  CONCLUSIONS
  Many participants failed to provide accurate CRC screening data, and validity varied greatly across individual CRC screening tests. Future CRC screening studies among Appalachian residents should use medical records, if possible, to determine screening histories.
authors.affiliation: Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, Ohio 43201, USA. Paul.Reiter@osumc.ed
authors.forename: Paul L
authors.initials: PL
authors.lastname: Reiter
authors.forename: Mira L
authors.initials: ML
authors.lastname: Katz
authors.forename: Jill M
authors.initials: JM
authors.lastname: Oliveri
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Young
authors.forename: Adana A
authors.initials: AA
authors.lastname: Llanos
authors.forename: Electra D
authors.initials: ED
authors.lastname: Paskett
mesh_terms: D000368:Aged; D003113:Colonoscopy / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009780:Occult Blood; D009820:Ohio; D017410:Practice Guidelines as Topic; D015203:Reproducibility of Results; D057566:Self Report; D012812:Sigmoidoscopy / Q000706:statistics & numerical data
keywords: Appalachia; cancer screening; colorectal cancer; validity